University of California, San Francisco.
Centers for Disease Control and Prevention, Atlanta, Georgia.
Arthritis Care Res (Hoboken). 2021 Jan;73(1):48-54. doi: 10.1002/acr.24398. Epub 2020 Dec 6.
Health-related quality of life (HRQoL) is reduced in systemic lupus erythematosus (SLE), partly driven by comorbid depression. Among patients with SLE, the association between major depression and HRQoL, measured using the NIH's Patient-Reported Outcomes Measurement Information System (PROMIS), is not well characterized. The objective was to determine an association between major depression and HRQoL as measured by PROMIS.
Cross-sectional data were obtained from the California Lupus Epidemiology Study, a cohort of adults in the San Francisco Bay Area with SLE. We studied the association between major depression (score ≥10 on the Patient Health Questionnaire 8 depression scale) and T scores (scaled to population mean ± SD of 50 ± 10) on 12 PROMIS domains representing physical, mental, and social health. Mean T scores in depressed and nondepressed individuals were compared using multiple linear regression models adjusting for age, sex, race/ethnicity, disease activity, damage, body mass index, and household income.
Mean age of the 326 participants was 45 years; ~89% were women, 29% White, 23% Hispanic, 10% African American, and 36% Asian. One-fourth met the criteria for major depression. In multivariable analyses, major depression was independently associated with worse T scores on all 12 PROMIS domains (P < 0.001); compared with those without major depression, depressed individuals scored >10 points (1 SD) worse on fatigue, sleep impairment, negative psychosocial impact of illness, satisfaction in discretionary social activities, and satisfaction in social roles.
In individuals with SLE, major depression is associated with markedly worse PROMIS scores in physical, mental, and social domains. Diagnosing and treating depression may help improve HRQoL in individuals with SLE.
红斑狼疮患者（SLE）的健康相关生活质量（HRQoL）降低，部分原因是合并抑郁。在 SLE 患者中，使用 NIH 的患者报告结局测量信息系统（PROMIS）测量的重度抑郁症与 HRQoL 之间的关联尚未得到很好的描述。本研究旨在确定 PROMIS 测量的重度抑郁症与 HRQoL 之间的关联。
从加利福尼亚狼疮流行病学研究（California Lupus Epidemiology Study）中获取了横断面数据，该研究是旧金山湾区患有 SLE 的成年人队列。我们研究了重度抑郁症（患者健康问卷 8 项抑郁量表得分≥10）与代表身体、心理和社会健康的 12 项 PROMIS 域的 T 评分（标准化为 50±10 的人群均值±标准差）之间的关联。使用多线性回归模型比较抑郁和非抑郁个体的平均 T 评分，模型调整了年龄、性别、种族/民族、疾病活动度、损伤、体重指数和家庭收入。
326 名参与者的平均年龄为 45 岁；约 89%为女性，29%为白人，23%为西班牙裔，10%为非裔美国人，36%为亚裔。四分之一的人符合重度抑郁症的标准。多变量分析显示，重度抑郁症与所有 12 项 PROMIS 域的 T 评分较差独立相关（P<0.001）；与无重度抑郁症的患者相比，抑郁患者在疲劳、睡眠障碍、疾病的负面心理社会影响、自主社会活动满意度和社会角色满意度方面的得分差了 10 分（1 个标准差）以上。
在 SLE 患者中，重度抑郁症与身体、心理和社会领域的 PROMIS 评分明显恶化相关。诊断和治疗抑郁症可能有助于改善 SLE 患者的 HRQoL。
